Gala
RSVP
FRIDAY EVENING, JANUARY 30, 2015 • ASIAN ART MUSEUM, 200 LARKIN STREET • 6:30 PM - 9:00 PM
Name: _____________________________________________________________________________________ Address: ___________________________________________________________________________________ City:_______________________________________ State:____________________ Zip: ___________________ Email:______________________________________ Phone:__________________________________________
Number of Individual Tickets @$100/person ($90/person if RSVP by 12/31/2014):___________________ Guest(s) Name(s):__________________________________________________________________________ I would like to sponsor a UCSF medical student/resident ($90) or contribute $________________ towards sponsoring a student/resident Total amount enclosed:____________________________________________________________________ Note: Please make check payable to San Francisco Medical Society or pay by credit card.
PAY M E N T I N F O Card Number:_____________________________________________________________________________ Expiration Date: ____________________________________ Billing Zip Code:______________________
RSVP deadline: January 19, 2015
Please mail your RSVP in the enclosed envelope to 1003A O’Reilly Avenue, San Francisco, CA 94129 Or, purchase your tickets online at http://www.sfms.org/Events/annualgala.aspx Questions or to RSVP by phone, call 415.561.0850 x260.
SFMS_AnnualDinner_RSVP_2015.indd 1
10/17/14 12:33 PM